蕭裕泉醫師眼科筆記

 Anit-inflammation Perfecting cataract surgery EyeWorld Supplement to EyeWorld August 2012 Inflammation remains a significant challenge to modern cataract surgery. Left untreated, inflammation can ruin even the most consummately performed surgery utilizing the most advanced techniques and technology. Experts gathered to discuss “Ocular Anti-Inflammation: Prevention, Diagnosis, and Curative Treatment Options” at an EyeWorld Educational Symposium held at the 2012 ASCRS•ASOA Symposium & Congress. The event was supported by an educational grant from ISTA Pharmaceuticals (Irvine, Calif.). NSAID issues 2012 “Cataract surgery is evolving,” said Dr. Katsev. According to Dr. Katsev, patients’ standards have been increasing in the last decade in part thanks to the increasing role of premium IOLs in cataract surgery. In that time, the use of premium IOLs has increased dramatically, he said, but the promise of great vision these IOLs make does not necessa...

Complicated cataract cases Cataract surgery in patients with Fuchs' dystrophy -------------------------------------------------------------------------------- by Brian Alder, M.D., and Terry Kim, M.D. Fuchs' dystrophy is the most common endothelial dystrophy affecting human corneas. Cataract is the most common ailment affecting the eye of older adults. The intersection of these two problems in the same eye is not uncommon. Many patients with cataract have mild to moderate guttata and stromal thickening at the time of cataract evaluation. In many cases it is not clear whether cataract or Fuchs' dystrophy contributes more to the decline in vision. Clinical judgment and experience are necessary to distinguish between the contributions. Sometimes it isn't known until after surgical intervention. In recent years, endothelial keratoplasty (DSAEK, DSEK, DMEK) replaced penetrating keratoplasty as the most common surgical procedure for treating adva...

The non-surgical option for vitreoretinal diseases -------------------------------------------------------------------------------- by Faith A. Hayden EyeWorld Staff Writer A graphic of the ocriplasmin molecule Source: ThromboGenics  A non-surgical treatment for symptomatic vitreomacular adhesion (VMA) including macular hole, vitreomacular traction syndrome (VMT), and epiretinal membrane (ERM) is now in the hands of the FDA. In April, ThromboGenics (Iselin, N.J.) submitted ocriplasmin for priority review by the agency, which could reach a decision on the drug by the end of the year. ThromboGenics is also pursuing European commercialization. Ocriplasmin could be available in Europe as early as October. "The product has been in development for eye diseases for about 5 years," said Ram Palanki, head of marketing, ThromboGenics. "We went through Phase I, II, and got our Phase III data in August of 2010. That's when we decided to go for the submis...

Steroid reliance too common in treating uveitis by Jena Passut EyeWorld Staff Writer -------------------------------------------------------------------------------- Although steroids are useful in treating uveitis (pictured here), long-term use results in side effects, such as cataracts Source: Manolette Roque, M.D. More training with uveitis experts is needed; disease is curable with immunosuppressive therapy Despite major inroads in the treatment of many ocular diseases, uveitis rates have remained nearly the same for the past 35 years. The disease has an estimated prevalence of 38 in 100,000. Of that, 10% of patients will become blind. "The reason that there has been no significant progress in driving down the prevalence in developed countries around the world is because of the exclusive reliance on steroid therapy by the bulk of ophthalmologists who care for patients with uveitis," said C. Stephen Foster, M.D., clinical professor of ophthalmology, Harva...